ANNEX II - Format for the list of the personal data of persons having regular access to inside information referred to in Article 2(1)

Info

Date and time of creation of this insider list:

[

yyyy-mm-dd, hh:mm UTC (Coordinated Universal Time)

]

Date and time (last update):

[

yyyy-mm-dd, hh:mm UTC (Coordinated Universal Time)

]

Date of transmission to the competent authority:

[

yyyy-mm-dd

]

First name(s)

of the insider

Surname(s)

of the insider

Surname(s)

of the insider at birth (if different)

Professional telephone number(s)

(work direct telephone line and work mobile numbers)

Company name and address

Function and reason for being insider

Obtained

(the date and time at which the insider obtained regular access to the inside information)

Ceased

(the date and time at which the insider ceased to have regular access to the inside information)

National Identification Number

(if applicable) or otherwise

Date of Birth

Personal full home address

(street name; street number; city; post/zip code; country) (If available at the time of the request by the competent authority)

Personal telephone numbers

(home and personal mobile telephone numbers)

[Text]

[Text]

[Text]

[Numbers (no space)]

[Address of issuer]

[Text describing role, function and reason for being on this insider list/]

[yyyy-mm-dd, hh:mm UTC]

[yyyy-mm-dd, hh:mm UTC]

[Number and/or text or yyyy- mm-dd for the date of birth]

[Text]

[Numbers (no space)]# Table 1 in anx_I

First name(s)of the insiderSurname(s)of the insiderSurname(s)of the insider at birth (if different)Professional telephone number(s)(work direct telephone line and work mobile numbers)Company name and addressFunction and reason for being insiderObtained(the date and time at which the insider obtained access to the inside information)Ceased(the date and time at which the insider ceased to have access to the inside information)National Identification- Number(if applicable)Date of birthPersonal tele- phone numbers(home and personal mobile telephone numbers)Personal full home address:street name; street number; city; post/zip code; country)
[Text][Text][Text][Numbers (no space)][Address of issuer/emission allowance market participant/auction plat- form/auctioneer/auction monitor or, of the person acting on their behalf or on their account[Text describing role, function and reason for being on this list][yyyy-mm-dd, hh:mm UTC][yyyy-mm-dd, hh:mm UTC][Number and/or text][yyyy-mm-dd][Numbers (no space)][Text]

Table 2 in anx_I

First name(s)of the insiderSurname(s)of the insiderSurname(s)of the insider at birth (if different)Professional telephone number(s)(work direct telephone line and work mobile numbers)Company name and addressFunction and reason for being insiderIncluded(the date and time at which the insider was included in the permanent insider section)National Identification Number(if applicable)Date of BirthPersonal full home address(street name; street number; city; post/zip code; country) (If available at the time of the request by the competent authority)Personal telephone numbers(home and personal mobile telephone numbers)
[Text][Text][Text][Numbers (no space)][Address of issuer or of the person acting on their behalf or on their account][Text describing role, function and reason for being on this list][yyyy-mm-dd, hh:mm UTC][Number and/or text]yyyy- mm-dd for the date of birth][Text][Numbers (no space)]

Table 1 in anx_II

First name(s)of the insiderSurname(s)of the insiderSurname(s)of the insider at birth (if different)Professional telephone number(s)(work direct telephone line and work mobile numbers)Company name and addressFunction and reason for being insiderObtained(the date and time at which the insider obtained regular access to the inside information)Ceased(the date and time at which the insider ceased to have regular access to the inside information)National Identification Number(if applicable) or otherwiseDate of BirthPersonal full home address(street name; street number; city; post/zip code; country) (If available at the time of the request by the competent authority)Personal telephone numbers(home and personal mobile telephone numbers)(If available at the time of the request by the competent authority)
[Text][Text][Text][Numbers (no space)][Address of issuer][Text describing role, function and reason for being on this insider list/][yyyy-mm-dd, hh:mm UTC][yyyy-mm-dd, hh:mm UTC][Number and/or text or yyyy- mm-dd for the date of birth][Text][Numbers (no space)]

Table 1 in anx_III

First name(s)of the insiderSurname(s)of the insiderProfessional telephone number(s)(work direct telephone line and work mobile numbers)Function or reason for being insiderObtained(the date and time at which the insider obtained access to the inside information)Ceased(the date and time at which the insider ceased to have access to the inside information)National Identification Number(if applicable)Or otherwiseDate of Birth
[Text][Text][Numbers (no space)][Text describing role, function and/or reason for being on this list][yyyy-mm-dd, hh:mm UTC][yyyy-mm-dd, hh:mm UTC][Number and/or text or yyyy-mm-dd for the date of birth]

Table 2 in anx_III

First name(s)of the insiderSurname(s)of the insiderProfessional telephone number(s)(work direct telephone line and work mobile numbers)Company name and addressFunction and reason for being insiderIncluded(the date and time at which the insider was included in the permanent insider section)National Identification Number(if applicable)Or otherwiseDate of Birth
[Text][Text][Numbers (no space)][Address of issuer or of the person acting on their behalf or on their account][Text describing role, function and reason for being on this list][yyyy-mm-dd, hh:mm UTC][Number and/or yyyy- mm-dd for the date of birth]